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NPI Code Detail

MEDICARE: MAKELSEA KAY MAYER RN

MEDICARE:   MAKELSEA KAY MAYER  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse14160359-3102UT

General Provider Information

NPI Number : 1780402073
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKELSEA KAY MAYER RN
Provider Business Mailing Address
First Line : 13521 S PARK PRESIDIO WAY UNIT 1403
Second Line :
City : DRAPER
State : UT
Zip : 84020-1989
Country : US
Telephone Number : 435-592-9886
Fax Number : 801-571-1338
Provider Business Practice Location Address
First Line : 4775 W DAYBREAK PKWY STE 102
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84009-5139
Country : US
Telephone Number : 435-592-9886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2024
Last Update Date : 09/26/2024

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